Myocardial Blood Flow and Flow Reserve After Coronary Reimplantation in Patients After Arterial Switch and Ross Operation

• DOI: 10.1161/01.cir.103.14.1875
• Publication Date: 2012-06-12T00:09:32Z
• Authors: Michael Hauser; Frank M. Bengel; Andreas Kühn; Ursula Sauer; Solvig Zylla; Siegmund L. Braun; Stephan G. Nekolla; Renate Oberhoffer; Rüdiger Lange; Markus Schwaiger; John Hess
• Keywords: Coronary flow reserve; Fractional Flow Reserve; Coronary arteries

Background —Coronary reimplantation is used in therapy for congenital heart disease, such as the arterial switch (ASO) and Ross operations. The adequacy of myocardial perfusion may remain a matter concern. aim present study was to stratify effect coronary on highlight clinical relevance any attenuation perfusion. Methods Results —A total 21 children with transposition great arteries at mean interval 11.2±2.9 years after ASO 9 adolescents 4.2±2.1 procedure were investigated. All patients asymptomatic had normal exercise capacity. On stress echocardiography, 2 dyskinetic areas within left ventricular myocardium, 5 adenosine-induced defects positron emission tomography. No obstruction detected angiography patient, but common finding right dominance small caliber distal part anterior descending artery. Coronary flow reserve (CFR) significantly reduced all when compared 10 healthy volunteers (age, 25.6±5.3 years). CFR who operation 19.2±7.6 years); exercise-induced not patients. Conclusions —Children are asymptomatic, without signs dysfunction. In contrast operation, stress-induced an attenuated documented. prognostic implications these findings consequences unclear; nevertheless, close follow-up mandatory.